Until recently, surgical repair was the standard treatment for an ostium secundum atrial septal defect (ASD), a common congenital heart defect. Closing ASDs using a device inserted via a catheter now offers another option for some patients. Limited comparative data indicate that newer approaches to transcatheter repair have a higher failure rate than that for surgery, but short-term complication rates are lower. Evidence from long-term follow-up of patients with device closure of ASDs is not yet available. Equipment and procedure costs may be higher for transcatheter closure than for surgery, but overall costs may be reduced through avoiding intensive care unit costs and through shorter hospital stays.